DR. RANDALL PHILLIPS (NPI# 1154304962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154304962 |
| Entity Type | Individual |
| Full Name | DR. RANDALL PHILLIPS |
| Credential | M.D. |
| Practice Address |
2780 Middle Country Rd Ste 210 Lake Grove NY 11755-2120 |
| Practice Telephone | 6315884500 |
| Practice Fax Number | 6315884595 |
| Mailing Telephone | 6315884500 |
| Mailing Fax Number | 6315884595 |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2017-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
146974 | NY | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4 Cobbler Ln, East Setauket, NY 117331168 | 9525951100 | 6122944903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104083997 | Randall Jerald Phillips | Dentist | 516 Candler St, Gainesville, GA 30501-3332 | 2008-05-20 |
| 1851662860 | Randall Austin Phillips Jr. | Social Worker | 301 Nw 63rd St, Suite 301, Oklahoma City, OK 73116-7907 | 2012-01-23 |
| 1295763183 | Randall R Phillips | Otolaryngology | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2006-06-29 |
| 1841248705 | Randall Phillips | Physical Therapist | 96 Macon Center Dr, Franklin, NC 28734-6779 | 2006-05-04 |
| 1124099395 | Randall Joseph Phillips | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2006-01-27 |
| 1306848940 | Randall Wallace Phillips | Marriage & Family Therapist | 367b N Parkway, Jackson, TN 38305-2865 | 2005-08-12 |
| Street Address |
2780 MIDDLE COUNTRY RD STE 210 |
| City | LAKE GROVE |
| State | NY |
| Zip Code | 11755-2120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699157586 | Roger Lee Kilfoil | Podiatrist | 20 Lindell Ave, Lake Grove, NY 11755 | 2015-06-26 |
| 1780070102 | Rebecca Au | Occupational Therapist | 43 Tulip Grove Drive, Lake Grove, NY 11755 | 2015-04-13 |
| 1154730943 | Nancy Allegretti | Counselor | 7 Oak Street, Lake Grove, NY 11755 | 2014-08-06 |
| 1548525074 | Dawnmarie Garrett | Case Manager/Care Coordinator | 62 Birch Street, Lake Grove, NY 11755 | 2012-07-11 |
| 1669775193 | Sonia Cristina Alonso Obregon | Speech-Language Pathologist | 6 Williams Blvd, Apto 1e, Lake Grove, NY 11755 | 2010-12-05 |
| 1932413135 | Melissa Ann Crimi | Registered Nurse | 2233 Nesconset Hwy Ste 207, Lake Grove, NY 11755 | 2010-07-29 |
| 1689991788 | Ny Theraapy Placemeny, Inc | General Acute Care Hospital | 162 Symphony Dr, Lake Grove, NY 11755 | 2010-04-28 |
| 1578886594 | Viviana Henrielte Florea | Nurse Practitioner | 3 Tower Street, First Floor, Lake Grove, NY 11755 | 2010-03-04 |
| 1194965897 | Susan Mary Byrne | Nurse Practitioner | 2780 Middle Country Road Suite 306, The Child and Family Wellness Center, Lake Grove, NY 11755 | 2009-02-20 |
| 1649449158 | Brian K. Berliner, O.d., P.C. | Optometrist | 64 Dsw Plaza, Lake Grove, NY 11755 | 2008-02-28 |
| Find all providers in zip 11755 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912096793 | Medical Arts Radiological Group, P.C. | Radiology | 570 Smith Haven Mall, Lake Grove, NY 11755-1206 | 2006-10-12 |
| 1033169404 | Alexandra B Perkins | Radiology | 2780 Middle Country Rd, Suite 210, Lake Grove, NY 11755-2124 | 2006-05-10 |
| 1588081889 | Medical Doctor Visit Me Pllc | Radiology | 570 Smith Haven Mall, Lake Grove, NY 11755-1206 | 2014-03-25 |
| 1760615793 | Suffolk Medical Imaging, PC | Radiology | 2780 Middle Country Road, Suite 210, Lake Grove, NY 11755 | 2009-08-25 |
| 1013027283 | Suffolk Breast Imaging PC | Radiology | 2780 Middle Country Rd, Suite 210, Lake Grove, NY 11755-2124 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558960690 | New York Medical Diagnostic Imaging PC | Radiology | 13617 39th Ave Ste 1d, Flushing, NY 11354-5504 | 2020-10-20 |
| 1700490034 | Hudson Valley Radiologists, PC | Radiology | 33 Bridgewater Way, Poughkeepsie, NY 12601-5961 | 2020-09-03 |
| 1730702986 | Hudson Valley Radiologists, PC | Radiology | 17 Argent Dr, Poughkeepsie, NY 12603-6040 | 2020-05-22 |
| 1114540366 | Hudson Valley Radiologists, PC | Radiology | 12 Caliguiri Ct, Lagrangeville, NY 12540-4912 | 2020-05-22 |
| 1831712082 | Hudson Valley Radiologists, PC | Radiology | 23 Sommerset Rd, Poughkeepsie, NY 12603 | 2020-05-22 |
| 1124641378 | Hudson Valley Radiologists, PC | Radiology | 49 Evergreen Ave, Poughkeepsie, NY 12601-5206 | 2020-05-22 |
| 1023631272 | Hudson Valley Radiologists, PC | Radiology | 3 Riding Ridge Trl, Beacon, NY 12508-7023 | 2020-05-22 |
| 1740803998 | Hudson Valley Radiologists, PC | Radiology | 36 Pine St Apt 229, Poughkeepsie, NY 12601-3974 | 2020-05-22 |
| 1215550462 | Hudson Valley Radiologists, PC | Radiology | 50 Leonard St Unit 106, Beacon, NY 12508-3455 | 2020-05-22 |
| 1285257519 | Hudson Valley Radiologists, PC | Radiology | 14 Hilee Rd, Rhinebeck, NY 12572-2347 | 2020-05-21 |
| Find all providers with the same taxonomy | ||||
| City | LAKE GROVE |
| Zip Code | 11755 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.